In this article
In the last chapter, we outlined types of care options available to adults with disabilities. These types of care can be costly. According to our research.
Key takeaways
- Disability care is extremely expensive: Personal care assistants cost around $33/hour, adult day programs run $100/day, and assisted living averages $194/day ($5,900/month) — costs that private insurance typically doesn’t cover but Medicaid may subsidize for qualifying low-income individuals.
- Medicaid is the primary government assistance: This federal-state program covers long-term care services for adults with permanent disabilities who meet income limits (typically $1,305-$1,330/month) and asset restrictions that vary by state.
- SSI and SSDI provide additional support: SSI offers monthly payments to low-income disabled adults (often automatically qualifying them for Medicaid), while SSDI provides benefits either through work history or if the person became disabled before age 22 and has a parent receiving Social Security benefits.
Average costs of care
- Personal care assistants. On average, people pay around $33 per hour for a personal care assistant, according to Genworth and CareScout.
- Adult day programs. The average cost per day is $100, according to Genworth and CareScout.
- Assisted living. The average daily cost of assisted living, per Genworth and CareScout, is $194. Monthly, that’s $5,900.
As you can see, disability care is expensive. What’s more, private insurance typically does not cover these kinds of care. Long-term care insurance may cover such services, but if you already need the care when you try to purchase it you may not be approved. However, the cost of care can be subsidized by government benefits — mainly through Medicaid.
What Is Medicaid?
Medicaid is a federal and state health insurance program for people with low income and limited financial assets. Like private insurance, Medicaid covers physician care and prescription medications; unlike private insurance, Medicaid covers personal care assistants and other kinds of long-term care.
If an adult has a permanent disability, they can qualify for Medicaid if they also meet income and asset restrictions. Those restrictions vary from state to state, but they can range from $1,305-$1,330 per month. Check with your local Medicaid office to find out your state’s rules.
Other government disability benefits
Supplemental Security Income (SSI). SSI makes monthly payments — which differ by state — to disabled adults over 18 who are low-income and have few financial resources. In most states if someone receives SSI, they also qualify for Medicaid.
Someone who received SSI as a child may continue to qualify after they turn 18. If they weren’t eligible as a child, they may qualify once they become an adult, so age 18 is a good time to look into this possibility. For an adult to qualify, they must meet the following criteria:
- You have a medically determinable physical or mental impairment expected to last 12+ months or result in death, with limited income and resources.
- You have under $2,000 in assets ($3,000 for couples).
- You have an income below specific thresholds, typically proving you cannot engage in “substantial gainful activity” (SGA), which is earning less than $1,690.
Social Security Disability Insurance (SSDI). There are two ways to access SSDI benefits as an adult: 1) if a person has a qualifying work history, they may receive benefits, OR 2) a person may receive benefits if they meet the following criteria:
- Became disabled before turning 22
- Currently over 18
- Unmarried, OR married to someone else who also receives SSDI
- Have a parent who receives Social Security retirement or disability benefits, OR have a deceased parent with a qualifying work history
- Social Security determines that disability prevents them from earning more than $1,170 a month. Unlike SSI, SSDI allows recipients to earn any amount of income while they receive benefits, but they still run the risk of losing their qualification if they earn too much.
Private financing options
This page from the U.S. Department of Health and Human Services has information on other ways people may finance the cost of care.
Deborah Elbaum, M.D. lives in Massachusetts and has three children.
